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Metabolic factors and the risk of small intestine cancers : Pooled study of 800 000 individuals in the metabolic syndrome and cancer project

Nagel, Gabriele ; Bjørge, Tone ; Jaensch, Andrea ; Peter, Raphael S. ; Häggström, Christel ; Lang, Alois ; Engeland, Anders ; Teleka, Stanley LU ; Jirström, Karin LU orcid and Lindquist, David , et al. (2021) In International Journal of Cancer 149(1). p.66-74
Abstract

To explore the largely unknown etiology of small intestine cancer, we examined metabolic factors and risk of small intestine cancer overall and by subtypes. Among 404 220 women and 403 265 men in six European cohorts, we applied Cox regression with adjustment for smoking and body mass index (BMI), to calculate sex-specific hazard ratios (HRs) of small intestine cancer by levels of BMI, mean arterial pressure (MAP) and plasma total cholesterol, triglycerides and glucose. We also calculated HRs for these factors combined (metabolic score; MetS) and used Wald test statistics to investigate pairwise interactions between metabolic factors on risk. We also performed analyses separately per subtype (neuroendocrine tumors [NETs] and... (More)

To explore the largely unknown etiology of small intestine cancer, we examined metabolic factors and risk of small intestine cancer overall and by subtypes. Among 404 220 women and 403 265 men in six European cohorts, we applied Cox regression with adjustment for smoking and body mass index (BMI), to calculate sex-specific hazard ratios (HRs) of small intestine cancer by levels of BMI, mean arterial pressure (MAP) and plasma total cholesterol, triglycerides and glucose. We also calculated HRs for these factors combined (metabolic score; MetS) and used Wald test statistics to investigate pairwise interactions between metabolic factors on risk. We also performed analyses separately per subtype (neuroendocrine tumors [NETs] and adenocarcinomas). During a median follow-up of 16.9 years, 144 women and 195 men were diagnosed with small intestine cancer, including 184 NETs and 99 adenocarcinomas. Among men, no main associations or interactions between metabolic factors were observed in relation to the risk of small intestine cancer. Among women, triglycerides were positively and linearly associated with risk (HR per standard deviation [SD]: 1.23, 95% confidence interval [CI]: 1.04-1.46), and a positive association was also observed for the MetS (HR per SD: 1.25, 95% CI: 1.02-1.52). Positive interactions were observed among women between triglycerides and cholesterol (P =.0005), and between MAP and glucose (P =.009), on risk. Glucose was positively associated with adenocarcinomas among women. This large, prospective study suggests that elevated triglycerides, and metabolic factors in interaction, confer an increased risk of small intestine cancer among women, but not among men.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Mecan, metabolic factors, risk factors, small intestine cancer
in
International Journal of Cancer
volume
149
issue
1
pages
9 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:85101916159
  • pmid:33634882
ISSN
0020-7136
DOI
10.1002/ijc.33530
language
English
LU publication?
yes
id
7127be00-9086-4a4b-b09d-fd9e02b50a96
date added to LUP
2021-12-09 14:10:15
date last changed
2024-06-01 21:45:15
@article{7127be00-9086-4a4b-b09d-fd9e02b50a96,
  abstract     = {{<p>To explore the largely unknown etiology of small intestine cancer, we examined metabolic factors and risk of small intestine cancer overall and by subtypes. Among 404 220 women and 403 265 men in six European cohorts, we applied Cox regression with adjustment for smoking and body mass index (BMI), to calculate sex-specific hazard ratios (HRs) of small intestine cancer by levels of BMI, mean arterial pressure (MAP) and plasma total cholesterol, triglycerides and glucose. We also calculated HRs for these factors combined (metabolic score; MetS) and used Wald test statistics to investigate pairwise interactions between metabolic factors on risk. We also performed analyses separately per subtype (neuroendocrine tumors [NETs] and adenocarcinomas). During a median follow-up of 16.9 years, 144 women and 195 men were diagnosed with small intestine cancer, including 184 NETs and 99 adenocarcinomas. Among men, no main associations or interactions between metabolic factors were observed in relation to the risk of small intestine cancer. Among women, triglycerides were positively and linearly associated with risk (HR per standard deviation [SD]: 1.23, 95% confidence interval [CI]: 1.04-1.46), and a positive association was also observed for the MetS (HR per SD: 1.25, 95% CI: 1.02-1.52). Positive interactions were observed among women between triglycerides and cholesterol (P =.0005), and between MAP and glucose (P =.009), on risk. Glucose was positively associated with adenocarcinomas among women. This large, prospective study suggests that elevated triglycerides, and metabolic factors in interaction, confer an increased risk of small intestine cancer among women, but not among men.</p>}},
  author       = {{Nagel, Gabriele and Bjørge, Tone and Jaensch, Andrea and Peter, Raphael S. and Häggström, Christel and Lang, Alois and Engeland, Anders and Teleka, Stanley and Jirström, Karin and Lindquist, David and Stattin, Pär and Ulmer, Hanno and Concin, Hans and Stocks, Tanja}},
  issn         = {{0020-7136}},
  keywords     = {{Mecan; metabolic factors; risk factors; small intestine cancer}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{66--74}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{International Journal of Cancer}},
  title        = {{Metabolic factors and the risk of small intestine cancers : Pooled study of 800 000 individuals in the metabolic syndrome and cancer project}},
  url          = {{http://dx.doi.org/10.1002/ijc.33530}},
  doi          = {{10.1002/ijc.33530}},
  volume       = {{149}},
  year         = {{2021}},
}